| NPI | 1639261407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY FITZPATRICK Administrator 516-832-8504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: NY 2905200R) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2015-10-02 |